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<br />Instructions for Completion of SF-LLL, Disclosure of Lobbying Activities
<br />
<br />This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt
<br />of a covered Federal action, or a material change to a previous filing, pursuant to title 31 U.S.C. section 1352. The filing of a form is required
<br />for each payment or agreement to make payment to any lobbying entity for influencing or attempting to influence an officer or employee
<br />of any agency. a Member of Congress. an officer or employee of Congress, or any employee of a Member of Congress in connection with
<br />a covered Federal action. Complete all items that apply for both the initial filing and material change report. Refer to the implementing
<br />guidance published by the Office of Management and Budget for additional information.
<br />
<br />1. Identify the type of covered Federal action for which lobbying
<br />activity is-andJot'has been secured to influence the outcome
<br />of a covered Federal action.
<br />2. Identify the status of the covered Federal action.
<br />3. Identify the appropriate classification of this report. If this is a
<br />followup report caused by a material change to the informa-
<br />tion previously reported, enter the year and quarter in which
<br />the change occurred. Enter the date of the last previously
<br />submitted report by this reporting entity for this covered
<br />Federal action.
<br />4. Enter the fuil name, address, city, state and zip code of the
<br />reporting entity. Include Congressional District, if known.
<br />Check the appropriate classification of the reporting entity
<br />that designates if it is, or expects to be, a prime or subaward
<br />recipient. Identify the tier of the subawardee, e.g., the first
<br />subawardee ofthe prime is the 1st tier. Subawards include but
<br />are not limited to subcontracts, subgrants and contract awards
<br />under grants.
<br />5. If the organization filing the report in item 4 checks
<br />.Subawardee", then enter the full name, address, city, state
<br />and Zip code of the prime Federal recipient, Include Congres-
<br />sional District, if known.
<br />6. Enter the name of the Federal agency making the award or
<br />loan commitment. Include at least one organizational level
<br />below agency name, if known. For example, Department of
<br />Transportation, United States Coast Guard.
<br />7. Enter the Federal program name or description for the cov-
<br />ered Federal action (item 1). If known, enter the full Catalog of
<br />Federal Domestic Assistance (CFDA) number for grants,
<br />cooperative agreements, loans, and loan commitments.
<br />8. Enter the most eppropriate Federal Identifying number avail-
<br />able for the Federal action identified in item 1 (e.g., Request
<br />for Proposal (RFP) number; Invitation for Bid (IFB) number;
<br />grant announcement number; the contract, grant, or loan
<br />award number; the application proposal control number as-
<br />signed by the Federal agency). Include prefixes, e.g., -RFP-
<br />DE-90-001."
<br />
<br />9. For a covered Federal action where there has been an award
<br />or loan commitment by the Federal agency, enter the Federal
<br />amount of the award/loan commitment for the prime entity
<br />identified in item 4 or 5.
<br />10. (a) Enter the full name, address, city, state and zip code of the
<br />registrant under the t.obbying Disclosure Act of 1995 engaged
<br />by the reporting entity identified in item 4 to influence the
<br />covered Federal action.
<br />(b) Enter the full names of the indlvidual(s) performing ser-
<br />vices, and include full address if different from 10 (a). Enter
<br />Last Name, First Name, and Middle Initial (MI).
<br />11. Enter the amount of compensation paid or reasonably ex-
<br />pected to be paid by the reporting entity (Item 4) to the
<br />lobbying entity (item 10). Indicate whether the payment has
<br />been made (actual) or will be made (planned). Check ail
<br />boxes that apply. If this is a material change report, enter the
<br />cumulative amount of payment made or planned to be made.
<br />12. Check the appropriate box (as). Check ail boxes that apply.
<br />If payment is made through an in-kind contribu1ion, specify the
<br />nature and value of the in-kind payment.
<br />13. Check the appropriate box (es). Check ail boxes that apply.
<br />If other, specify nature.
<br />14. Provide specific and detailed description of the services that
<br />the lobbist has performed, or will be expected to perform, and
<br />the date(s) of any services rendered. Include all preparatory
<br />and related activity, not just the time spent in actual contact
<br />with Federal officiais. Identify the Federal offlcial(s) or
<br />employee(s) contacted or the officer(s), employee(s), or
<br />Member(s) of Congress that were contacted.
<br />15. Check whether or not a continuation sheet(s) are attached.
<br />16. The certifying officiai shall sign and date the form, print his/her
<br />name, title, and telephone number.
<br />
<br />Public Reporting Burden for this collection of information is estimated to average 30 minutes per response, including the time for reviewing instructions,
<br />searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Please do not
<br />return your completed form to the Office of Management and Budget; send it to the address provided by the sponsoring agency.
<br />Send comments regarding the burden estimate or any other aspect of this collection of information, Including suggestions for reducing this burden, to the
<br />Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, DC 20503.
<br />
<br />Authorized for Local Reproduction
<br />Standard Form-LLL (7/97)
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